An empirical study for medication delivery improvement based on healthcare professionals’ perceptions of medication delivery system

Medication errors are major safety concerns in all hospital settings. The insufficient knowledge about managerial and process improvement strategies required to reduce medication errors can be considered as one of the most important factors holding back hospitals from achieving the desired goals for patient safety. However, strategies for medication error reduction cannot be successfully implemented without a clear understanding of factors affecting medication delivery errors. This paper presents a study in which healthcare professionals’ perceptions on three factors, namely (1) technical complexity of tasks/connections; (2) resources problems; and (3) qualification of human resources, are analyzed within the medication delivery system at one community hospital. The outcomes of this research are a theoretical model for reducing medication delivery errors and a set of workflow design rules for healthcare professionals to continuously reduce medication delivery errors.     

Knowledge, Attitude and Practice of Health-Care Waste Management and Associated Health Risks in the Two Teaching and Referral Hospitals in Kenya

Hazardous health-care waste poses a great danger to public health and the environment if it is not properly managed. There is need for health-care workers involved in its management to understand the integral link between human health and environmental health. This study was done to identify gaps in knowledge, attitude and practice among the healthcare workers involved in its management hence endangering public health and polluting the environment. A self administered questionnaire was used in both Kenyatta National Hospital, Nairobi and Moi Teaching and Referral Hospital, Eldoret to clinicians, nurses, laboratory technologists and hospital attendants to identify the gaps with a focus on their knowledge, attitude and practice. It was found that health and safety in health-care waste management, was not included in most of the curricula for training the three healthcare professionals. Most of them acquired this through on-job training from seminars and informally through organized talks at work-places. The hospital attendants had also an opportunity to acquire the knowledge through organized training at work places. The training improved the workers’ compliance to hepatitis B vaccinations and use of personal protective equipment when handling health-care waste. There was also reduction on injuries from health-care waste. This study therefore concludes that it is necessary for healthcare workers training curricula to include health and safety issues while managing hazardous health-care waste as well as establishes the need for healthcare institutions to conduct continuing education on health and safety in the management of health-care waste.     

门诊药房取药系统的设计与实现

本文详述了我院门诊药房取药系统的数据结构及与医院信息系统（HIS）的数据接口的实现方法．并给出了相应的SQL语句。本系统已在我院运行2年,优化了门诊取药流程。     

医疗废物全过程管理在医院手术室的实施

目的 加强手术室医疗废物全过程管理,控制医院感染.方法 以国务院《医疗废物管理条例》及《军队医疗卫生机构医疗废物管理办法》为准则,建立全程无盲区管理方式,规范手术室医疗废物的分类收集、运送和暂时贮存的工作流程和要求,健全、完善各项规章制度.结果 手术室医疗废物的管理质量得到提高,各级人员环保意识加强,有效控制医院感染.结论 实施手术室医疗废物全过程管理,是控制医院感染的重要途径.     

High priority research needs for gestational diabetes mellitus

Abstract Objective: Identification of unanswered research questions about the management of gestational diabetes mellitus (GDM) is necessary to focus future research endeavors. We developed a process for elucidating the highest priority research questions on GDM. Methods: Using a systematic review on GDM as a starting point, we developed an eight-step process: (1) identification of research gaps, (2) feedback from the review's authors, (3) translation of gaps into researchable questions using population, intervention, comparators, outcomes, setting (PICOS) framework, (4) local institutions' stakeholders' refinement of research questions, (5) national stakeholders' use of Delphi method to develop consensus on the importance of research questions, (6) prioritization of outcomes, (7) conceptual framework, and (8) evaluation. Results: We identified 15 high priority research questions for GDM. The research questions focused on medication management of GDM (e.g., various oral agents vs. insulin), delivery management for women with GDM (e.g., induction vs. expectant management), and identification of risk factors for, prevention of, and screening for type 2 diabetes in women with prior GDM. Stakeholders rated the development of chronic diseases in offspring, cesarean delivery, and birth trauma as high priority outcomes to measure in future studies. Conclusions: We developed an eight-step process using a multidisciplinary group of stakeholders to identify 15 research questions of high clinical importance. Researchers, policymakers, and funders can use this list to direct research efforts and resources to the highest priority areas to improve care for women with GDM.     

2019年某院碳青霉烯类抗菌药物及替加环素使用情况分析

目的了解该院碳青霉烯类抗菌药物及替加环素的使用情况,探讨其合理性,为临床合理用药提供参考。方法通过HIS系统,汇总分析该院2019年1—12月使用碳青霉烯类及替加环素的出院病历140份,参照相关指南及评价细则,对合理性进行专项点评。结果140份病历中,会诊率为90.00%,用药前微生物送检率为79.29%,用药不合理病历为17例,其中用法用量不适宜9例,联合用药不适宜4例,无适应证用药的4例。结论该院碳青霉烯类抗菌药物及替加环素的使用仍存在不合理的情况,应加强抗菌药物临床应用管理,促进抗菌药物临床的合理应用。     

我院2013年1~12月的儿科住院患者抗菌药物使用情况分析

目的了解和掌握医院儿科住院患者抗菌药物使用情况,为临床合理用药及管理提供参考依据。方法回顾性分析随机抽取的395份2013年1-12月的我院儿科出院病历的资料,对抗菌药物名称、价格、剂量、使用频度、给药途径、联合用药、送检情况及用药合理性进行分析和评价。结果抗菌药物使用率为87.85%,其中治疗性用药298例,预防性用药49例;给药途径均为静脉给药,部分患儿结合口服或雾化吸入给药;抗菌药物品种以青霉素类、头孢菌素类、大环内酯类为主;联合用药者共62例,占17.87%,其中二联用药60例,三联用药2例;标本送检率为12.39%,其中检出阳性率为23.26%;用药合理或基本合理者共309例,占89.05%,不合理者共38例,占10.95%。结论儿科住院病例仍存在不合理用药情况,主要体现在使用剂量过大、联合用药不当、选用品种不合理、无指证用药等方面。     

医疗废物管理系统的开发与应用研究

目的：在数字化医疗医院示范中,通过应用现代信息技术,对医疗废物的回收、存放及处置等环节进行实时跟踪和监管,使医疗废物管理更加规范。方法：基于无线网络、条形码及射频识别（RFID）等技术,开发医疗废物管理信息系统并在医院进行应用实践。结果：系统对医院内部医疗废物的收集、运送、贮存以及处置等过程进行了有效的控制及监管。结论：医疗废物管理系统规范了废物收运环节,增强了透明性,确保了安全,提升了医院管理水平。     

以创新方式提高医院医疗废物追溯管控水平

目的按照国家卫健委等部门关于医疗机构废弃物综合治理的工作要求,结合医院实际情况,以创新的方式加强医疗机构医疗废物追溯管理,实现医疗废物“看得见、摸得着、管得住”的核心目标。方法通过信息化追溯系统和智能收集终端,建立完善的医疗废物追溯管控体系,全面加强医院医疗废物的监管,规范医疗废物管理工作人员的行为,全过程跟踪医疗废物从产生、分类、收集、交接、转运、贮存和清运交接的整个流程。结果医疗废物追溯管控体系实现了医疗废物的实时监控和预警管理,减低了院感风险,提高了收集效率,降低了工作难度,规范了工作人员的行为模式,提升了医院医疗废物追溯的整体管控水平。结论医疗废物的信息化管控是医疗机构运营管理的重要方面,也是全面推进智慧医院建设的重要环节。     

公立医院改革要从五方面着手

我国公立医院面临着城乡间和地区间差距大,虽机构数量比重不高,但床位、人员比重过高,财政补偿机制不健全,政府对公立医院的治理关系不清晰,医院人事制度与医疗服务活动特点不相适应,医务人员薪酬不合理等问题。借鉴国外公立医院改革经验,结合我国实际,应重点进行转变机构运行经费投入方式、改革医院基本建设投入方式、调整医疗服务价格体系、改善政府对公立医院的治理和加强公立医院内部管理等五方面的综合改革。